Drug/Small Molecule:
fluticasone propionate

PharmGKB contains no dosing guidelines for this drug/small molecule. To report known genotype-based dosing guidelines, or if you are interested in developing guidelines, click here.

PharmGKB annotates drug labels containing pharmacogenetic information approved by the US Food and Drug Administration (FDA), European Medicines Agency (EMA) and the Pharmaceuticals and Medical Devices Agency, Japan (PMDA). PharmGKB annotations provide a brief summary of the PGx in the label, an excerpt from the label and a downloadable highlighted label PDF file. A list of genes and phenotypes found within the label is mapped to label section headers and listed at the end of each annotation. PharmGKB also attempts to interpret the level of action implied in each label with the "PGx Level" tag.

Sources:

  • FDA Information is gathered from the FDA's "Table of Pharmacogenomic Biomarkers in Drug Labels" and from FDA-approved labels brought to our attention. Please note that drugs may be removed from or added to the FDA's Table without our knowledge. We periodically check the Table for changes and update PharmGKB accordingly. Drugs listed on the Table to our knowledge are tagged with the Biomarker icon. A drug label that has been removed from the Table will not have the Biomarker icon but will continue to have an annotation on PharmGKB stating the label has been removed from the FDA's Table. We acquire label PDF files from DailyMed.
  • EMA European Public Assessment Reports (EPARs) that contain PGx information were identified from [Article:24433361] and also by searching for drugs for which we have PGx-containing FDA drug labels.

We welcome any information regarding drug labels containing PGx information approved by the FDA, EMA, PMDA or other Medicine Agencies around the world - please contact feedback.


FDA Label for fluticasone propionate

Full label available at DailyMed

Genes and/or phenotypes found in this label

  • Asthma
    • Indications & usage section, Contraindications section, Warnings section, Adverse reactions section, Precautions section
    • source: PHONT
  • Cushing Syndrome
    • Warnings section, Adverse reactions section, Precautions section
    • source: PHONT
  • Pulmonary Disease, Chronic Obstructive
    • Indications & usage section, Contraindications section, Warnings section, Adverse reactions section, Precautions section
    • source: PHONT

PharmGKB contains no Clinical Variants that meet the highest level of criteria.

To see more Clinical Variants with lower levels of criteria, click the button at the bottom of the page.

Disclaimer: The PharmGKB's clinical annotations reflect expert consensus based on clinical evidence and peer-reviewed literature available at the time they are written and are intended only to assist clinicians in decision-making and to identify questions for further research. New evidence may have emerged since the time an annotation was submitted to the PharmGKB. The annotations are limited in scope and are not applicable to interventions or diseases that are not specifically identified.

The annotations do not account for individual variations among patients, and cannot be considered inclusive of all proper methods of care or exclusive of other treatments. It remains the responsibility of the health-care provider to determine the best course of treatment for a patient. Adherence to any guideline is voluntary, with the ultimate determination regarding its application to be made solely by the clinician and the patient. PharmGKB assumes no responsibility for any injury or damage to persons or property arising out of or related to any use of the PharmGKB clinical annotations, or for any errors or omissions.

? = Mouse-over for quick help

This is a non-comprehensive list of genetic tests with pharmacogenetics relevance, typically submitted by the manufacturer and manually curated by PharmGKB. The information listed is provided for educational purposes only and does not constitute an endorsement of any listed test or manufacturer.

A more complete listing of genetic tests is found at the Genetic Testing Registry (GTR).

PGx Test Variants Assayed Gene?

The table below contains information about pharmacogenomic variants on PharmGKB. Please follow the link in the "Variant" column for more information about a particular variant. Each link in the "Variant" column leads to the corresponding PharmGKB Variant Page. The Variant Page contains summary data, including PharmGKB manually curated information about variant-drug pairs based on individual PubMed publications. The PMIDs for these PubMed publications can be found on the Variant Page.

The tags in the first column of the table indicate what type of information can be found on the corresponding Variant Page.

Links in the "Gene" column lead to PharmGKB Gene Pages.

List of all fluticasone propionate variant annotations

Gene ? Variant?
(142)
Alternate Names ? Drugs ? Alleles ?
(+ chr strand)
Function ? Amino Acid?
Translation
No VIP available No Clinical Annotations available VA
rs1786929 18483512A>G, 67679048A>G
A > G
Not Available
No VIP available CA VA
rs1876828 1065+310C>T, 1107+111C>T, 1194+111C>T, 43911525C>T, 54898C>T, 582+111C>T, 9185677C>T, 955985A>A, 987+111C>T, CRHR1:rs1876828
A > G
Intronic
No VIP available No Clinical Annotations available VA
rs1876829 1065+228T>A, 1065+228T>C, 1065+228T>G, 1107+29T>A, 1107+29T>C, 1107+29T>G, 1194+29T>A, 1194+29T>C, 1194+29T>G, 43911443T>A, 43911443T>C, 43911443T>G, 54816T>A, 54816T>C, 54816T>G, 582+29T>A, 582+29T>C, 582+29T>G, 9185595T>A, 9185595T>C, 9185595T>G, 956067G>C, 956067G>G, 956067G>T, 987+29T>A, 987+29T>C, 987+29T>G
G > A
Intronic
No VIP available No Clinical Annotations available VA
rs1876831 31-38C>T, 436-38C>T, 43907745C>T, 51118C>T, 556-38C>T, 643-38C>T, 9181897C>T, 959796A>A
A > G
Intronic
No VIP available No Clinical Annotations available VA
rs242939 -285+1631C>A, -285+1631C>G, -285+1631C>T, 122-3142C>A, 122-3142C>G, 122-3142C>T, 241+1631C>A, 241+1631C>G, 241+1631C>T, 38952T>A, 38952T>G, 38952T>T, 43895579C>A, 43895579C>G, 43895579C>T, 9169731C>A, 9169731C>G, 9169731C>T, 971962A>A, 971962A>C, 971962A>T, CRHR1:rs242939
A > G
Intronic
No VIP available No Clinical Annotations available VA
rs242941 -404-1310A>C, -404-1310A>G, -404-1310A>T, 122-1310A>C, 122-1310A>G, 122-1310A>T, 122-6202A>C, 122-6202A>G, 122-6202A>T, 35892C>C, 35892C>G, 35892C>T, 43892520A>C, 43892520A>G, 43892520A>T, 9166672A>C, 9166672A>G, 9166672A>T, 975003G>A, 975003G>C, 975003G>G, CRHR1:rs242941
G > T
Intronic
No VIP available No Clinical Annotations available VA
rs2569190 -121-139T>C, -221-39T>C, -260T>C, 1175843A>G, 140012916A>G, 5371T>C
A > G
Intronic
No VIP available No Clinical Annotations available VA
rs2872507 3314915G>A, 38040763G>A
G > A
Not Available
No VIP available No Clinical Annotations available VA
rs35599367 20493C>T, 37399159G>A, 522-191C>T, 99366316G>A, CYP3A4*22
G > A
Intronic
No VIP available No Clinical Annotations available VA
rs3752120 -266G>A, 24820239C>T, 52552021C>T
C > T
5' UTR
No VIP available CA No Variant Annotations available
rs37973 -1106G>A, 4503G>A, 7997876G>A, 8007876G>A
G > A
5' Flanking
No VIP available No Clinical Annotations available VA
rs739645 -285+1042T>A, -285+1042T>C, -285+1042T>G, 122-3731T>A, 122-3731T>C, 122-3731T>G, 241+1042T>A, 241+1042T>C, 241+1042T>G, 38363T>A, 38363T>C, 38363T>G, 43894990T>A, 43894990T>C, 43894990T>G, 9169142T>A, 9169142T>C, 9169142T>G, 972552C>C, 972552C>G, 972552C>T
C > A
Intronic
No VIP available No Clinical Annotations available VA
rs967676 15234461T>C, 279+48041A>G, 49960309T>C
T > C
Intronic
Alleles, Functions, and Amino Acid Translations are all sourced from dbSNP 142
2D structure from PubChem
provided by PubChem

Overview

Generic Names
  • fluticasone propionate
Trade Names
  • Advair Diskus
  • Advair Diskus 100/50
  • Advair Diskus 250/50
  • Advair Diskus 500/50
  • Cutivate
  • Flixonase
  • Flixotide
  • Flonase
  • Flovent
  • Flovent Diskus 100
  • Flovent Diskus 250
  • Flovent Diskus 50
  • Flovent HFA
  • Flunase
Brand Mixture Names

PharmGKB Accession Id:
PA449686

Description

Fluticasone propionate, a medium-potency synthetic corticosteroid, is used topically to relieve inflammatory and pruritic symptoms of dermatoses and psoriasis, intranasally to manage symptoms of allergic and non-allergic rhinitis, and orally for the treatment of asthma.

Source: Drug Bank

Indication

For the maintenance treatment of asthma as prophylactic therapy and for patients requiring oral corticosteroid therapy for asthma.

Source: Drug Bank

Other Vocabularies

Information pulled from DrugBank has not been reviewed by PharmGKB.

Pharmacology, Interactions, and Contraindications

Mechanism of Action

Binds to the glucocorticoid receptor. Unbound corticosteroids cross the membranes of cells such as mast cells and eosinophils, binding with high affinity to glucocorticoid receptors (GR). The results include alteration of transcription and protein synthesis, a decreased release of leukocytic acid hydrolases, reduction in fibroblast proliferation, prevention of macrophage accumulation at inflamed sites, reduction of collagen deposition, interference with leukocyte adhesion to the capillary wall, reduction of capillary membrane permeability and subsequent edema, reduction of complement components, inhibition of histamine and kinin release, and interference with the formation of scar tissue. In the management of asthma, the glucocorticoid receptor complexes down-regulates proinflammatory mediators such as interleukin-(IL)-1, 3, and 5, and up-regulates anti-inflammatory mediators such as IkappaB inhibitory molecule for nuclear factor kappaB1, IL-10, and IL-12. The antiinflammatory actions of corticosteroids are also thought to involve inhibition of cytosolic phospholipase A2 (through activation of lipocortin-1 (annexin)) which controls the biosynthesis of potent mediators of inflammation such as prostaglandins and leukotrienes.

Source: Drug Bank

Pharmacology

Fluticasone propionate, a medium-potency synthetic corticosteroid, is used topically to relieve inflammatory and pruritic symptoms of dermatoses and psoriasis, intranasally to manage symptoms of allergic and non-allergic rhinitis, and orally for the treatment of asthma.

Source: Drug Bank

Absorption, Distribution, Metabolism, Elimination & Toxicity

Biotransformation

Fluticasone propionate is metabolized in the liver by cytochrome P450 3A4-mediated hydrolysis of the 5-fluoromethyl carbothioate grouping. This transformation occurs in 1 metabolic step to produce the inactive 17-(beta)-carboxylic acid metabolite, the only known metabolite detected in man.

Source: Drug Bank

Protein Binding

91%

Source: Drug Bank

Absorption

The extent of percutaneous absorption of topical corticosteroids is determined by many factors, including the vehicle and the integrity of the epidermal barrier.

Source: Drug Bank

Half-Life

10 hours

Source: Drug Bank

Clearance

  • 1093 mL/min

Source: Drug Bank

Volume of Distribution

  • 2.3 to 16.7 L/kg

Source: Drug Bank

Chemical Properties

Chemical Formula

C25H31F3O5S

Source: Drug Bank

Isomeric SMILES

CCC(=O)O[C@@]1([C@@H](C[C@@H]2[C@@]1(C[C@@H]([C@]3([C@H]2C[C@@H](C4=CC(=O)C=C[C@@]43C)F)F)O)C)C)C(=O)SCF

Source: Drug Bank

CCC(=O)[O-].C[C@@H]1C[C@H]2[C@@H]3C[C@@H](C4=CC(=O)C=C[C@@]4([C@]3([C@H](C[C@@]2([C@]1(C(=O)SCF)O)C)O)F)C)F

Source: OpenEye

Canonical SMILES

CCC(=O)O[C@@]1([C@H]

Source: Drug Bank

Average Molecular Weight

500.571

Source: Drug Bank

Monoisotopic Molecular Weight

500.184429407

Source: Drug Bank

PharmGKB Curated Pathways

Pathways created internally by PharmGKB based primarily on literature evidence.

PharmGKB contains no curated pathways for this drug. If you would like to volunteer to work on a pathway, please let us know.

External Pathways

Links to non-PharmGKB pathways.

  1. chromatin remodeling by hswi/snf atp-dependent complexes - (BioCarta via Pathway Interaction Database)
  2. corticosteroids and cardioprotection - (BioCarta via Pathway Interaction Database)

Genes that are associated with this drug in PharmGKB's database based on (1) variant annotations, (2) literature review, (3) pathways or (4) information automatically retrieved from DrugBank, depending on the "evidence" and "source" listed below.

Curated Information ?

Drug Targets

Gene Description
NR3C1 (source: Drug Bank)
NR3C2 (source: Drug Bank)
PGR (source: Drug Bank)
PLA2G4A (source: Drug Bank)
SERPINA6 (source: Drug Bank)
No related drugs are available.

Curated Information ?

Publications related to fluticasone propionate: 21

No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Adoption of a clinical pharmacogenomics implementation program during outpatient care-initial results of the University of Chicago "1,200 Patients Project". American journal of medical genetics. Part C, Seminars in medical genetics. 2014. O'Donnell Peter H, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available VA No VIP available No VIP available
Polymorphisms in recent GWA identified asthma genes CA10, SGK493, and CTNNA3 are associated with disease severity and treatment response in childhood asthma. Immunogenetics. 2014. Perin Petra, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available VA No VIP available No VIP available
Inhaled corticosteroid treatment modulates ZNF432 gene variant's effect on bronchodilator response in asthmatics. The Journal of allergy and clinical immunology. 2013. Wu Ann Chen, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available VA No VIP available No VIP available
Fluticasone Propionate Pharmacogenetics: CYP3A4*22 Polymorphism and Pediatric Asthma Control. The Journal of pediatrics. 2013. Stockmann Chris, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Tailored second line therapy in asthmatic children with the arginine-16 genotype. Clinical science (London, England : 1979). 2012. Lipworth Brian J, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available VA No VIP available No VIP available
Association among ORMDL3 gene expression, 17q21 polymorphism and response to treatment with inhaled corticosteroids in children with asthma. The pharmacogenomics journal. 2012. Berce V, et al. PubMed
No Dosing Guideline available No Drug Label available CA No Variant Annotation available No VIP available No VIP available
Predicting inhaled corticosteroid response in asthma with two associated SNPs. The pharmacogenomics journal. 2012. McGeachie M J, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available VA No VIP available No VIP available
Pharmacogenetics of asthma controller treatment. The pharmacogenomics journal. 2012. Mougey E B, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
Association of hypothalamic-pituitary-adrenal axis-related polymorphisms with stress in asthmatic children on inhaled corticosteroids. Neuroimmunomodulation. 2012. Tsartsali Lemonia, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available VA No VIP available No VIP available
CD14 gene polymorphism is not associated with asthma but rather with bronchial obstruction and hyperreactivity in Slovenian children with non-atopic asthma. Respiratory medicine. 2011. Perin Petra, et al. PubMed
No Dosing Guideline available No Drug Label available CA No Variant Annotation available No VIP available No VIP available
Genomewide association between GLCCI1 and response to glucocorticoid therapy in asthma. The New England journal of medicine. 2011. Tantisira Kelan G, et al. PubMed
No Dosing Guideline available No Drug Label available CA No Variant Annotation available No VIP available No VIP available
Association between CRHR1 polymorphism and improved lung function in response to inhaled corticosteroid in patients with COPD. Respirology (Carlton, Vic.). 2009. Kim Woo J, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Functional pharmacogenetics/genomics of human cytochromes P450 involved in drug biotransformation. Analytical and bioanalytical chemistry. 2008. Zanger Ulrich M, et al. PubMed
No Dosing Guideline available No Drug Label available CA VA No VIP available No VIP available
Pharmacogenomics and outcome of asthma: no clinical application for long-term steroid effects by CRHR1 polymorphisms. The Journal of allergy and clinical immunology. 2008. Dijkstra Antoon, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Effect of ADRB2 polymorphisms on response to longacting beta2-agonist therapy: a pharmacogenetic analysis of two randomised studies. Lancet. 2007. Bleecker Eugene R, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Salmeterol and fluticasone propionate and survival in chronic obstructive pulmonary disease. The New England journal of medicine. 2007. Calverley Peter M A, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Ritonavir-fluticasone interaction causing Cushing syndrome in HIV-infected children and adolescents. The Pediatric infectious disease journal. 2006. Arrington-Sanders Renata, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Biotransformation of fluticasone: in vitro characterization. Drug metabolism and disposition: the biological fate of chemicals. 2006. Pearce Robin E, et al. PubMed
No Dosing Guideline available No Drug Label available CA No Variant Annotation available No VIP available No VIP available
Corticosteroid pharmacogenetics: association of sequence variants in CRHR1 with improved lung function in asthmatics treated with inhaled corticosteroids. Human molecular genetics. 2004. Tantisira Kelan G, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
Inhibition of VCAM-1 expression in human bronchial epithelial cells by glucocorticoids. American journal of respiratory cell and molecular biology. 1999. Atsuta J, et al. PubMed
No Dosing Guideline available No Drug Label available No Clinical Annotation available No Variant Annotation available No VIP available No VIP available
In vitro glucocorticoid receptor binding and transcriptional activation by topically active glucocorticoids. Arzneimittel-Forschung. 1998. Smith C L, et al. PubMed

LinkOuts

National Drug Code Directory:
0462-0333-15
DrugBank:
DB00588
ChEBI:
31441
KEGG Drug:
D01708
PubChem Compound:
444036
PubChem Substance:
46506140
Drugs Product Database (DPD):
2244293
ChemSpider:
392059
Therapeutic Targets Database:
DAP001039
FDA Drug Label at DailyMed:
8664a829-6b81-4249-8252-3d20f93097dc

Clinical Trials

These are trials that mention fluticasone propionate and are related to either pharmacogenetics or pharmacogenomics.

Common Searches

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Sources for PharmGKB drug information: DrugBank, Open Eye Scientific Software.